Pediatric Cartilage Interleave Tympanoplasty

2007 ◽  
Vol 137 (2) ◽  
pp. 284-288 ◽  
Author(s):  
Michael Gaslin ◽  
Robert C. O'Reilly ◽  
Thierry Morlet ◽  
Michael McCormick
Keyword(s):  
Tympanic Membrane ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Care Hospital ◽  
Membrane Repair ◽  
Hearing Results ◽  
Cartilage Tympanoplasty ◽  
Long Term Follow Up

OBJECTIVE: To describe a novel technique of cartilage tympanoplasty, and review surgical and hearing results in children. STUDY DESIGN AND SETTING: Retrospective chart review of all patients who had undergone tympanoplasty at a pediatric tertiary care hospital from August 2002 to July 2005. Forty-two patients were identified with a minimum follow-up time of 12 months. RESULTS: Mean preoperative perforation size was 21.3 percent (range 10%-90%), and mean patient age was 7.9 years (range 3-16 years). Median clinical follow-up was 24 months. Tympanic membrane closure and graft integration were achieved in 40 of 42 patients (95.2%), and 35 of 42 (85.7%) patients maintained an intact, stable tympanic membrane on long-term follow-up. A total of 93.8 percent of patients achieved a postoperative air-bone gap of less than or equal to 20 dB, and mean improvement in the air-bone gap was 10.7 dB. CONCLUSION AND SIGNIFICANCE: Cartilage interleave tympanoplasty is a versatile, stable, and effective technique for tympanic membrane repair in children.

Clinical profile and outcome of acute nephritic syndrome in children from a tertiary care centre in south India: a descriptive study

2017 ◽  
Vol 4 (3) ◽  
pp. 769
Author(s):  
Shemeena Valiyat ◽  
Harsha T. Valoor
Keyword(s):  
South India ◽  
Tertiary Care ◽  
Descriptive Study ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Nephritic Syndrome ◽  
Long Term Follow Up ◽  
Acute Nephritic Syndrome

Background: Acute nephritic syndrome (ANS) is major cause of morbidity in developing countries. This study is an attempt to evaluate the clinical characteristics, complications and outcome of acute nephritic syndrome.Methods:This hospital based descriptive study was conducted at a tertiary care hospital in Kerala, South India. 103 children with ANS were analysed. Detailed clinical examination and relevant laboratory investigations were done. These children were followed up for 1 year.Results: Out of 103 patients studied 64% were male and 36% were female. The peak age group was 6 to 8 years. Skin infection was the most common predisposing condition (68.9%). Hypertension was present in 60.1% of patients. 26.2% of patients developed complications. Of these Acute renal failures was the most commonly encountered complication (18.4%). Proteinuria (87.4%) and microscopic hematuria (80.6%) were the most consistent features.  82.5 % patients had low C3 at the time of diagnosis. Majority of patients with low C3 level had positive ASO titre. (p = 0.014). At 3month follow up C3 became normal in 95.2% of patients. At 3 months’ majority of patients with normal C3 had incomplete recovery. (p = 0.010). At the end of 12m, microscopic heamaturia was present in 4 patients, persistent hypertension in 2 patients, 11 patients had proteinuria. These patients are kept under long term follow up.Conclusions:Complications and morbidity is significantly high during the acute phase in ANS. This study highlights the need for long term follow up of these patients. 

scholarly journals Percutaneous Vertebroplasty Using a Rotary Cutter for Treating Kümmell’s Disease with Intravertebral Vacuum Cleft

2021 ◽  
pp. E477-E482
Keyword(s):  
Percutaneous Vertebroplasty ◽  
Tertiary Care ◽  
Control Group ◽  
Care Hospital ◽  
Long Term Follow Up ◽  
Kummell’S Disease ◽  
And Control ◽  
Kümmell’S Disease

BACKGROUND: Reported data indicate that the curative effect of percutaneous vertebroplasty (PVP) on the patients with intravertebral vacuum cleft (IVC) is worse than on those without IVC. OBJECTIVES: This study was to prospectively investigate the advantage of rotary cutter-PVP (RC-PVP) in patients with Kümmell’s disease with IVC. STUDY DESIGN: A prospective outcome study. SETTING: A tertiary care hospital. METHODS: Patients who underwent conventional PVP served as the control group. For the RC-PVP group, the rotary cutters were applied before the cement injection to destroy the IVC structure and the surrounding necrotic bone. The following data were compared between the two groups: the cement filling patterns, effective therapeutic rate, the pre- to post-procedural changes of spinal geometry, and the subsequent fractures. RESULTS: This study included a total of 64 patients (30 and 34 patients in RC-PVP group and control group, respectively). In the RC-PVP group, the cement in 26 cases was filled as a mixed pattern, while the filling pattern in the control group was mainly the cystic type (n = 31). There were no significant differences in the height restoration rate between the RC-PVP and control groups (32.7 ± 13.6 and 32.4 ± 13.9, respectively, P = 0.93). The RC-PVP group had a higher effective rate during the first week and the first month (93.3% vs. 70.6%, P = 0.02) and at 3 months (90.4% vs. 73.9%, P = 0.03). Long-term follow-up indicated that vertebral recollapse of the same treated vertebral body occurred in 5 patients after conventional PVP, which was not observed in the RC-PVP group. LIMITATIONS: The small number of included patients and no long-term follow-up. CONCLUSIONS: RC-PVP, with the destruction of IVC, may lead to better clinical outcomes with fewer complications. KEY WORDS: Back pain, bone cements, osteonecrosis, vertebroplasty

scholarly journals Adherence to Long-Term Follow-up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation

OTO Open ◽  
2021 ◽  
Vol 5 (3) ◽  
pp. 2473974X2110366
Author(s):  
Mallory Raymond ◽  
Arian Ghanouni ◽  
Kaitlyn Brooks ◽  
Sarah M. Clark ◽  
Douglas E. Mattox
Keyword(s):  
Vestibular Schwannoma ◽  
Tumor Size ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Long Term Follow Up ◽  
Lost To Follow Up

Objectives To examine the long-term adherence to serial imaging of patients with sporadic vestibular schwannoma and analyze factors associated with being lost to follow-up. Study Design Retrospective chart review with telephone interview. Setting Single tertiary care center. Methods Patients with a sporadic vestibular schwannoma and started on observational surveillance management between January 2005 and December 2010 were included. Demographic data, tumor size, hearing and vestibular changes, and follow-up length were recorded. Patient factors were analyzed for association with being lost to follow-up. Results In total, 122 patients were included with a median length of follow-up of 5 months (range, 0-146). After initial surveillance, 22.1% (n = 27) of patients had a change in management to either microsurgery or radiosurgery. Of the remaining 77.9% (n = 95), nearly half (44.2%, n = 42) never returned for a second visit, and all but 3 were eventually lost to follow-up. There was no association between sex, race, age at diagnosis, initial tumor size, insurance status, household income, or driving distance to hospital and being lost to follow-up. Of 26 interviewed patients initially lost to follow-up, 11 (42.3%) sought care at another institution, 5 (19.2%) chose to no longer receive care, 1 (3.8%) had transportation difficulties, and 9 (36.4%) had poor understanding of their diagnosis or instructions. Conclusions The length of follow-up for patients undergoing surveillance of sporadic vestibular schwannoma varies widely, and patients are commonly lost to follow-up. Further efforts should be made to identify at-risk patients and provide adequate education to improve long-term surveillance.

Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

2020 ◽  
pp. 112067212097604
Author(s):  
Reem R Al Huthail ◽  
Yasser H Al-Faky
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Nasal Endoscope ◽  
Long Term Follow Up ◽  
Mean Size ◽  
External Dacryocystorhinostomy ◽  
The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

scholarly journals Postoperative Hypoparathyroidism: Presentation, Clinical Features and Long-term Follow-up from Tertiary Care Hospital

2021 ◽  
Author(s):  
Shrikrishna V Acharya
Keyword(s):  
Vitamin D ◽  
Tertiary Care ◽  
Renal Ultrasound ◽  
Care Hospital ◽  
Clinical Complications ◽  
Treatment Prevalence ◽  
Postoperative Hypoparathyroidism ◽  
Long Term Follow Up ◽  
Considerable Morbidity

Introduction: Hypoparathyroidism is commonly seen after total thyroidectomy. Though most of the time it is transient in nature but permanent decrease in function of the parathyroid function is also possible. Aim: A retrospective analysis of clinical presentation, treatment, prevalence of complications of hypoparathyroidism and its treatment with active vitamin D analogues was conducted. Materials and Methods: A retrospective cohort study followed by location and duration of study of all patients who developed Permanent Hypoparathyroidism (PH) and who were regular in follow-up for at least three years. Any patient with intact Parathyroid Hormone (iPTH) levels <13 pg/mL and was on replacement therapy with calcium and/or vitamin D for at least one year after surgery is labelled as PH. Data of their treatment, serum calcium, phosphorous, creatinine, urine calcium/creatinine ratio and renal ultrasound was recorded. Data was represented as percentage, mean and standard deviation. Statistical analysis was conducted using SPSS version 19. Results: Out of the 23 patients enrolled, three were male and 20 were female with a mean age of 41.2±15.2 years. The mean duration of follow-up was 48±28 months. Clinical complications in 12 patients were observed. Two patients developed renal colic due to renal stone on follow-up. None of the patients developed renal failure. Conclusion: PH causes considerable morbidity and economic burden to family due to its lifelong treatment and monitoring. It requires regular follow-up and monitoring to prevent complications of disease as well as its treatment with active calcium salts. Around 50% of the patients suffered few relevant clinical events requiring hospitalisation.

scholarly journals Spinal cord hemangioblastomas with a focus on clinical presentation, diagnosis, and treatment at a tertiary care hospital of Karachi, Pakistan: A retrospective chart review

2021 ◽  
Vol 12 ◽  
pp. 24
Author(s):  
Syed Sarmad Bukhari ◽  
Muhammad Ehsan Bari ◽  
Nasir Ud Din ◽  
Zubair Ahmad
Keyword(s):  
Spinal Cord ◽  
Stromal Cells ◽  
Tertiary Care ◽  
Neuron Specific Enolase ◽  
Retrospective Chart Review ◽  
Vascular Tumors ◽  
Care Hospital ◽  
Mitotic Figures ◽  
Cluster Of Differentiation

Background: Hemangioblastomas are benign neoplasms that consist of stromal cells and small blood vessels. They are highly vascular tumors and can arise throughout the central nervous system. This study aims to provide an overview of our experience with this rare tumor’s presentation, radiology, histopathology, and outcomes as literature regarding this pathology is sparse from our country. Methods: The study is a retrospective review of cases that were histopathology proven cases of spinal cord hemangioblastomas. The clinical characteristics of these patients were examined, and their presentation was recorded. The radiology was also reviewed to describe classic appearance on magnetic resonance imaging. A detailed review of immunohistochemistry was also performed and outcome was described. Results: A total of 25 cases of spinal hemangioblastomas were found in our records in the period of 2001–2019. There were 20 males (80%) and only 5 female patients (20%). Gross tumor fragments ranged in size from 0.24 cm2 to 10.5 cm2 (mean 3.28 ± 2.65). Histologically, tumor was composed of nests of large stromal cells with clear to vacuolated cytoplasm separated by thin-walled capillaries. Focal intratumoral hemorrhage was noted. No significant cytological atypia or mitotic figures were noted. Immunohistochemical stains were performed to confirm the diagnosis and exclude other tumors. Inhibin was tested in 20 cases and it was positive in 16 cases (80%). Neuron-specific enolase was positive in 6/8 cases. Cluster of differentiation (CD) CD68 was positive in 6/6 cases and vimentin in 4/4 cases. Glial fibrillary acidic protein (GFAP) and epithelial membrane antigen were performed in 14 and 8 cases, respectively, and all were negative. Cytokeratin AE1/AE3 was negative in 13/13 cases. CD34 highlighted vasculature in the 8 cases in which it was performed and was negative in tumor cells. Follow-up was available in 17 out of 25 cases and ranged from 12 months to 216 months (mean 61.8 ± 60.6 months). Recurrence occurred in 2 out of 17 (11.7%) patients for whom follow-up information was available. Conclusion: Our experience shows that spinal cord hemangioblastomas can be surgically removed in most cases with a low risk of recurrence. Most patients in our study were male and unlike other studies, none of our cases showed GFAP positivity.

scholarly journals Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2760
Author(s):  
Manimegalai R. ◽  
Suganthi R.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Family Health ◽  
Common Reason ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Medical College

Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.

Carcinoids of the ampulla: Long-term follow-up after endoscopic resection.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 430-430
Author(s):  
George Nyasha Baison ◽  
Nadav Sahar ◽  
Morgan M Bonds ◽  
Janelle F Rekman ◽  
Flavio G. Rocha ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Care Center ◽  
Benign Lesion ◽  
Tertiary Care ◽  
Case Series ◽  
World Health ◽  
Long Term Follow Up ◽  
Well Differentiated

430 Background: Neuroendocrine tumors (NET) or carcinoids of the ampulla are exceedingly rare in comparison to duodenal NET. Surgical management is widely accepted as the treatment of choice, but for patients that refuse surgery or are poor operative candidates, endoscopic resection may be option. We present a consecutive case series at a tertiary care center describing our experience with endoscopic resection of ampullary NET. Methods: This is a restrospective review with a long-term follow-up of patients with ampullary NET that were endoscopically resected. Outcomes were analyzed based on the histopathologic classification system proposed by the World Health Organization in 2000. Results: Twelve patients (9 male, 3 female), ranging in age from 41 to 86 (mean 59) underwent endoscopic ampullectomy for ampullary NET, with a mean follow-up time of 5 years. Patients had refused surgery or were poor surgical candidates. All, but one incidentally found case, were symptomatic on presentation, with gastrointestinal bleeding being the main symptom. No patients had a hormonal syndrome. The mean size of the lesions was 21 mm (6 mm to 35 cm). Six (50%) patients had a well-differentiated, benign lesion, 6 (50%) patients had a well-differentiated NET with unknown malignant potential (gangliocytic paragangliomas). Eight (67%) were completely excised during the initial endoscopy with 4 requiring re-excision. Only 2 patients developed recurrence, after 2.5 and 10 years and this necessitated a pancreaticoduodenectomy. Five patients had complications (2 for bleeding and 3 for post-ERCP pancreatitis), with zero deaths. Conclusions: Unlike duodenal carcinoids, ampullary NET are rare. Pancreaticoduodenectomy can be offered to fit patients except for gangliocytic paragangliomas that do not require an aggressive operation. However, for those that refuse surgery or are poor candidates, endoscopic ampullectomy can be an option with acceptable short and long-term outcomes.

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